This application is submitted by the Johns Hopkins University and ORC Macro in response to PA-04-019, which encourages applications focusing on the Center for Mental Health Services' (CMHS) Comprehensive Community Mental Health Services for Children and Their Families Program. Since 1993, CMHS has provided funding to 121 grantees to develop service systems to provide a comprehensive spectrum of mental health and other support services to children with serious emotional disturbance (SED) and their families. We are proposing to analyze data available from approximately 69,000 youth served and 28,000 youth enrolled in the monitoring component of the study in order to investigate racial/ethnic, gender, and age differences in the characteristics of youth entering the program and disparities in the services received and outcomes. The project has three aims. Aim 1. Describe characteristics of youth at baseline for all 121 Service Programs initiated since 1993 (and any added during the study period) and identify trends in these baseline characteristics across this time period. Aim 2. Investigate the potential disparities at baseline and in treatment outcomes for youth enrolled in the program. Aim 3. Identify the determinants of treatment trajectories and also the determinants of disparities in treatment outcomes over time. We hypothesize that the characteristics of youth served will vary over time and that disparities in outcomes will become less over time. This research will identify gaps in our current services and the extent to which disparities remain a challenge, even in our nation's model program. [unreadable] [unreadable] [unreadable]